needle poking feeling in throat


If you are one of those people who suffer from needle poking in the throat area and want to know the cause of this annoying feeling in the throat, we recommend to read the following.

In the following, we will discuss the pain of throat attacks, which is referred to in medicine as Glossopharyngeal neuralgia, and this disorder, which can cause annoying pain and needle poking in the throat.


What you will read next:




What is Glossopharyngeal neuralgia?

What causes glossopharyngeal neuralgia?







Glossopharyngeal neuralgia is a rare disorder in the function of the ninth pair of nerves in the brain, the lingual-pharyngeal nerve or the glossopharyngeal nerve.

Normally, neuralgia can be uncomplicated, but there is an important risk in this neuralgia, And the danger is that this pain may be accompanied by an excessive decrease in heart rate or even asystole, ie no heartbeat, It means the heart does not beat.

In the following, we will explain more about this shooting and annoying pain.



The prevalence of this pain is estimated to be approximately 0.7 per 100,000 adult population worldwide.

People over the age of 50 are at higher risk for developing the disorder.


What is glossopharyngeal neuralgia?

Attacking pain in the throat, which is a rare disorder, and in this disorder, like other types of neuralgia, there will be sharp and sharp shooting attacks for only a few seconds.

A person with glossopharyngeal neuralgia, will not feel pain between the attacks of the throat.

It is said that a pain attack can start after swallowing and chewing, eating, talking.

The pain of this neuralgia starts around the ear, After the pain starts, it spreads to the end of the tongue, the surrounding tonsils, the lower jaw and even the neck.


Because the pharyngeal nerve and the vagus nerve are anatomically close to each other, in rare cases the development of glossopharyngeal neuralgia can simultaneously stimulate the vagus nerve. If this nerve is stimulated, it is associated with a decrease in heart rate. Therefore, Therefore, if stimulation occurs simultaneously in the pharyngeal and vagus nerves, the person may experience a sharp drop in heart rate and even heart failure or asystole in addition to the annoying sore throat.


What causes glossopharyngeal neuralgia?

Doctors say that most cases of this neuralgia occur for no reason, but it is also said that in some people it may occur for other reasons, ie secondary to other causes, for example, people who have head and neck masses are said to be more at risk of developing this neuralgia, If a person has sharp and shooting pain attacks in the throat, especially if there is a vague, mild, low-intensity pain between attacks, we must consider the possibility of a mass or tumor in him and reject these space-absorbing masses in him. Glossopharyngeal neuralgia presents with unilateral pain in the base and back of the tongue, ear canal, and pharynx. The pain can be excruciating and continuous. Some people say that they have this pain many times during the day. Doctors say that if there are any of the following, diagnostic tests should be done to find other diagnoses, such as MS, CP angel tumors, and carcinomas of the back of the nose and throat:

  • If the symptoms are bilateral, ie. the person has a burning pain in both sides of the throat
  • if the person has abnormal signs and symptoms.
  • If the person has unusual and atypical accompaniments and manifestations.



In the diagnosis process, in addition to the history and obtaining a history of individual and family diseases and the list of drugs used, according to the appropriate conditions, clinical examinations such as direct pharyngeal examination, esophageal endoscopy, laryngoscopy or direct laryngeal observation and nasal endoscopy is performed.

As we have said, because one of the causes of pain, especially bilateral pain and burning in the throat, can be tumors of the back of the nose and throat, so these tests are necessary:

  • Simple x-ray photo
  • CT Scan
  • M.R.I

It is said that in a person with neuralgia, imaging will usually be normal, sometimes in resolution MRIs; Small vascular pressure is seen on the pharyngeal lingual nerve.



If you have a sudden burning pain and severe sore throat, you may want to seek treatment.

Doctors say there are two ways to treat this neuralgia:

Medication and medical interventions are possible.


  • Medication:

The drug treatment of glossopharyngeal neuralgia is as follows:

The first line of drug treatment is a drug called carbamazepine.

If you respond quickly to carbamazepine treatment, this prompt response may indicate that your doctor has made a correct diagnosis. glossopharyngeal neuralgia responds rapidly to carbamazepine.

Treatment with carbamazepine is usually started at a dose of 200 mg at bedtime and gradually increased by another 200 mg every two days If the pain improves or the drug reaches the maximum allowable daily dose of one thousand two hundred milligrams or severe side effects occur, the dose of the drug at the previous level with which you have the best therapeutic response will be maintained and will continue with the same dose.

The important point in a person being treated with carbamazepine is that the person needs to be re-evaluated with a blood test and a blood cell count. This person should have frequent blood cell counts. In the event of any abnormality in the complete blood cell count or skin lesions, the drug should be discontinued immediately.

In a person who cannot be treated with carbamazepine, another drug is used that is called gabapentin.

This is how gabapentin is used to glossopharyngeal neuralgia. It starts with the initial dose of 300 mg at bedtime and every two days a 300 mg dose is added to the previous dose until this process continues until one of the cases The following occur:

Either the drug reaches the maximum allowable daily dose of 1,800 mg in twenty-four hours or severe side effects occur.

Or the person's pain improves, at this time, the drug will be maintained and continued with the previous dose, for example, if a person’s pain improves with nine hundred mg per day, the drug will continue with the same dose, if the person does not respond to carbamazepine and gabapentin or cannot use those drugs. The third alternative is baclofen. Treatment is started at the initial dose of 10 mg at bedtime. Ten mg is added to the previous dose every five days until it reaches a maximum dose of 80 mg in twenty-four days or the pain improves or Severe side effects occur.


In all of the above treatments, a complete biochemical blood cell count, a complete urine test serum, is required. Previous tests are also necessary during the intermittent monitoring period of treatment.


  • Interventional therapies:

We said that another treatment modality was the use of interventional therapies. Interventional therapeutic interventions include the following:

  • Nerve block
  • Lingual pharyngeal neurolysis


The pharyngeal lingual nerve is known as the ninth nerve of the brain. This nerve, along with several other nerves, namely the vagus nerve, the accessory nerve, and the internal jugular vein, exit from a hole in the floor and base of the skull called the jugular foramen and enters the lateral surface of the neck from the right and left. and they are located in the neck next to the important internal carotid artery.

The pharyngeal lingual nerve is located just behind the temporalis of the temporal bone between the mastoid appendage and the mandibular angles. Nerve blockade and neurolysis occur in exactly the same way.

Patients who are not completely relieved of their pain by nerve block are then considered for nerve neurolysis.

An anesthesiologist can perform lingual-throat neurolysis in two ways:


  1. Lingual pharyngeal neurolysis with radio frequency waves


  1. Lingual pharyngeal neurolysis with drugs


It is usually recommended to use a combination of drug therapy in addition to interventional therapy in the treatment of severe and sudden attacks of throat. The combination of these therapies always brings better results.

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